Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New "Leave Me Alone" Lesion with a Characteristic Imaging Pattern

AJNR Am J Neuroradiol. 2017 Oct;38(10):1899-1904. doi: 10.3174/ajnr.A5281. Epub 2017 Jul 13.

Abstract

Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. We report 33 cases of presumed multinodular and vacuolating neuronal tumor of the cerebrum that exhibit a remarkably similar pattern of imaging findings consisting of a subcortical cluster of nodular lesions located on the inner surface of an otherwise normal-appearing cortex, principally within the deep cortical ribbon and superficial subcortical white matter, which is hyperintense on FLAIR. Only 4 of our cases are biopsy-proven because most were asymptomatic and incidentally discovered. The remaining were followed for a minimum of 24 months (mean, 3 years) without interval change. We demonstrate that these are benign, nonaggressive lesions that do not require biopsy in asymptomatic patients and behave more like a malformative process than a true neoplasm.

MeSH terms

  • Adult
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology*
  • Cerebrum
  • Female
  • Ganglioneuroma / diagnostic imaging*
  • Ganglioneuroma / pathology*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neurons / pathology
  • White Matter / diagnostic imaging
  • White Matter / pathology